|HCT-ALB| Difference Value In The Diagnosis Of Severe Tsutsugamushi

[Objective]Exploring the feasibility of the |HCT-ALB| difference in the diagnosis of severe tsutsugamushi disease,providing a quick and effective method for clinical.[Methods]The CRF form was used to collect the clinical data of 408 patients with tsutsugamushi disease admitted to 37 hospitals in 15 prefectures of Yunnan Province from January 1,2008 to December 31,2018.According to the diagnostic criteria of tsutsugamushi disease,they were divided into mild tsutsugamushi disease group(n=265 cases)and severe tsutsugamushi disease(n=143 cases),the healthy population of Kunming City Medical Center in Yunnan Province as a healthy control group(n=5000 cases),each patient's HCT value,ALB value,LDH value were collected.And UA values,and APACHE II score and SOFA score for each patient,calculate the difference of |HCT-ALB| for each patient;collect the HCT value and ALB value of healthy people,and calculate the difference of |HCT-ALB| value.Statistical analysis was performed using SPSS 21.0 statistical software.The measurement data in accordance with the normal distribution were expressed as X±s.One-way ANOVA and t-test were used for comparison between groups.|HCT-ALB|The difference was obtained by two independent samples.t test,analysis|HCT-ALB| difference in the diagnosis of patients with severe ascariasis ROC curve,the selection of the best diagnostic indicators using positive likelihood ratio determination,while the use of severe tsutsugamushi patients | HCT-ALB| difference and their LDH Value,UA value,APACHE II score,and Pearson correlation analysis of SOFA scores were statistically significant at P<0.05.[Results]1.There was no significant difference in gender composition between patients with mild tsutsugamushi disease and severe ascariasis(P>0.05).Compared with the mild tsutsugamushi disease group,the age of severe tsutsugamushi disease group increased(year:53.57±15.23 to 35.03±23.47,P<0.05).2.Compared with the healthy control group,the HCT value of the mild tsutsugamushi disease group and the HCT value of the severe tsutsugamushi disease group decreased[HCT:(36.53516.82)%,(38.132±7.60)%ratio(46.205±4.42)%,P<0.05].3.Compared with the healthy control group,the ALB value of the mild tsutsugamushi disease group and the ALB value of the severe tsutsugamushi disease group decreased[ALB(g/L):35.534±5.87,26.897±6.10 to 47.750±4.28,P<0.05].4.Compared with the mild tsutsugamushi disease group,the ALB value of the severe tsutsugamushi disease group decreased[ALB(g/L):26.897±6.10 to 35.534±5.87,P<0.05].5.Compared with the healthy control group,the HCT-ALB | difference was increased in the mild tsutsugamushi group(|HCT-ALB|difference:5.28±3.90 vs.1.55±5.32,P<0.05);6.Compared with healthy controls Compared with the group,the severity of HCT-ALB| was increased in the severe tsutsugamushi group(|HCT-ALB|difference:11.26±6.62 vs.1.55±5.32,P<0.05);7.Compared with the mild tsutsugamushi group,severe The tsutsugamushi disease group|HCT-ALB|difference difference(|HCT-ALB|difference:11.26±6.62 vs 5.28±3.90,P<0.05);8.Pearson correlation analysis,severe tsutsugamushi disease group|HCT-ALB There was a significant correlation between the difference and the LDH value(P<0.05);there was a significant correlation between the difference between the severe tsutsugamushi disease group and the UA value(P<0.05);the severe tsutsugamushi disease group|HCT-ALB There was a significant correlation between the difference and the APACHE II score(P<0.05);there was a significant correlation between the HCT-ALB| difference and the SOFA score in the severe tsutsugamushi group(P<0.05).9.By plotting the ROC curve,the area under the curve is 0.786,indicating that the |HCT-ALB| difference has good accuracy in the diagnosis of severe ascariasis.The corresponding standard error is 0.024,P=0.000,95%.The letter interval is(0.739,0.832).By calculating the positive likelihood ratio index,the best diagnostic value was determined to be 8.56.The sensitivity at this point was 81.1%,the specificity was 60.8%,and the Yoden index was 0.419.[Conclusions]1.Patients with severe tsutsugamushi have increased vascular permeability and are older;2.When the difference of | HCT-ALB | difference in patients with tsutsugamushi disease is above 8.56,it can be used as an indicator to identify mild ascariasis and severe ascariasis.;3.In addition to APACHE ? score,SOFA score,LDH value and UA value as the severity assessment of tsutsugamushi disease,|HCT-ALB| difference can be used as an indicator of the severity of tsutsugamushi disease,and more simple.